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Long-term Outcomes of Moderate to Severe Brain Injuries Studied

A recent study of outcomes among military veterans five or more years after moderate-to-severe traumatic brain injury has produced mixed findings. The study, conducted by researchers from the Defense and Veterans Brain Injury Center and three civilian hospitals, analyzed information from interviews with 119 one-time recipients of acute inpatient TBI rehabilitation. The interviews took place five to 16 years after injury, and were designed to assess occupational, educational, and social reintegration, independence in functioning, and cognitive, neurologic, and psychiatric symptoms.

A majority of those surveyed showed successful functioning in at least one phase of life: more than half were working or studying, one third were married, and one third had no persistent disability. However, varying degrees of deficits were also apparent: community integration was lacking on average, one quarter of the respondents had moderate or severe disability, and most individuals evinced at least one cognitive, neurological, or psychiatric symptom.

The study serves to highlight that although the vast majority of individuals who sustain mild traumatic brain injuries (concussions) will fully recover in days and weeks following concussion, those who sustain moderate to severe brain injuries have a more uncertain outcome. Moderate to severe TBI outcome is generally based on the location and severity of the injury. For example, in this study, greater durations of loss of consciousness and post-traumatic amnesia were moderately to strongly associated with occupational functioning and strongly associated with disability ratings. In evaluating any TBI claim, it is important to determine not only the severity of the TBI, but also whether there is evidence indicating a poor outcome.